Value (Business Strategy and Financial Management)
EP-147 - The Virtual Care Effect on Patient Access at Brigham Health
Sunday, April 29
3:45 PM - 4:00 PM
Location: Education Zone, Booth 2416, Screen 5
Adam Licurse, MD
Medical Director of Virtual Care
Brigham Health and Partners Healthcare, Center for Population Health
Many health care systems increasingly face challenges with patient access; Brigham Health (Boston, MA) is not an exception. Our institution has realized value in using virtual care pilot programs to improve patient access. In 2016 the average ambulatory appointment lag time at Brigham and Women's Hospital was fourteen days for surgical departments, and thirty-six days in non-surgical departments. In addition, only forty percent of patients were seen within the timeframe requested by a referring primary care physician. Overall, eighty percent of ambulatory visits are for follow up care, hindering provider's ability to meet new patient demand.
In efforts to provide care for existing patients while accommodating new patient demand, our team is strategically expanding three key virtual care programs: virtual visits, eVisits, and eConsults. We strongly believe that expansion will improve patient access, engagement and experience.
As we scale our virtual visits program across the institution, we are targeting specific surgical and medical specialties with access challenges and strategic value to the organization. The specialty providers determine each patient's clinical appropriateness for program enrollment. Patients have enjoyed the convenience and flexibility that virtual visits offer, and by reducing or eliminating time needed for the waiting room, administrative duties, and rooming, providers typically complete a virtual visit in half the time scheduled for a routine office visit. This efficiency directly improves access by allowing office visits to become available for new or complex established patients. We will describe this effect with our organizational dashboard designed around telehealth.
The Brigham Health E-Visit program consists of a virtual tool that improves patients' access to their primary care providers (PCPs). The patient completes an online questionnaire; the provider reviews the patient's answers and determines the plan of care. The goal of the E-Visit tool is to control the PCP clinic's urgent primary care walk-in traffic. Providers are often able to virtually recommend at-home treatment for minimal severity conditions; thus, fewer patients need a provider's office visit time. In addition to this patient initiated process, we will pilot provider-initiated E-Visits in the near future. Our presentation will illustrate the E-Visit program's effect on PCP access and project E-Visits' expanded effects after we implement provider-initiated E-Visits.
Finally, providers, often PCPs, refer patients to specialists when they lack the expertise to diagnosis or treat a specific condition. Oftentimes, these referrals are clinically appropriate, but in many cases providers are able to treat the patient with appropriate specialty-specific information. The E-Consult program allows providers to virtually connect with specialists within the EHR to ask patient-specific clinical questions. The responding E-Consultant (specialist) offers expert advice and treatment recommendations. By keeping low severity patient care in a lower cost setting, specialists are able to prioritize new or complex follow up patients. We will demonstrate E-Consults' effect on patient access in our virtual care dashboard.
At the ATA conference, our team will share our lessons learned in scaling our virtual care pilots into organization-wide programs and present an evaluation dashboard used to assess virtual care's effects on patient access.
- Upon completion, participants will be able to describe our strategies, goals and lessons learned in expanding from small virtual care pilots to organization-wide programs.
- Upon completion, participants will be able to demonstrate how we measure the value and impact that ambulatory virtual care has on clinical access in specialty departments.
- Upon completion, participant will be able to outline how a large academic medical center spread virtual care across varied departments, practices, and providers.